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Objectives: We primarily aimed to investigate the hematologic inflammatory parameters such as mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in patients with acromegaly. We also aimed to reveal the importance of these parameters in determining disease activity. Methods: The medical data of 535 patients with acromegaly were retrospectively reviewed. The sociodemographic characteristics, presence of comorbid disease, acromegaly-related clinical and medical treatment characteristics, insulinlike growth factor-1 and growth hormone levels at diagnosis, postoperative 3rd month and last visit, and hematologic inflammatory markers and indices at last visit were obtained from the patients' medical charts. The patients were divided into age-, sex-, and comorbid disease-matched four groups according to their last remission status: active disease, remission with only surgery, remission with medication, and discordant disease. Finally, a total of 290 patients were included. Results: We examined a total of 290 patients with acromegaly after primary therapy; 36 had active disease, 77 were in remission with only surgery, 129 were in remission with medication, and 48 had a discordant disease. When the patients were categorized by last remission status, the median MPV was higher in patients with discordant disease than in the remission group with only surgery, and there were no differences in terms of the NLR and PLR between groups. When the participants were divided into two groups according to the presence of remission at the postoperative 3rd month, patients who had remission had lower MPV levels than those who had not. However, the groups had similar features for the NLR and PLR. Conclusion: Our results, particularly those that reveal positive association between MPV and remission status, indicate that subclinical inflammation may play a role in increased mortality and morbidity. Therefore, in addition to patients with active disease, patients with discordant disease should be followed closely for cardiovascular risks. [ABSTRACT FROM AUTHOR]